What are the treatment options for ATIN?
- • Withdrawal of offending agent
- • Corticosteroid therapy
- • Steroid-sparing immunosuppressive therapy
To date, the optimal treatment for ATIN is unclear. There have been no randomized, controlled trials investigating the use of immunosuppressive therapy for treatment of ATIN.
Corticosteroids may be considered in patients with biopsy-proven ATIN in whom there is prolonged and/or progressive kidney dysfunction despite withdrawal of the offending agent.
There is no standardized treatment regimen for ATIN. Typically oral prednisone is started at 1 mg/kg per day and tapered off over 8 to 12 weeks.
Preddie et al. reported the use of mycophenolate mofetil (MMF) for 13 to 34 months in a group of patients who were steroid dependent for up to 6 months.
For now, one may consider the use of MMF for those who have biopsy-proven ATIN, who are either intolerant of, dependent on, or resistant to corticosteroids.
